This project aims to assess the efficacy of two widely used psychological interventions for chronic back pain, each based on a different rationale. Study I compared patients randomly assigned to (a) a waiting list control condition, (b) group cognitive therapy and relaxation training, and (c) group behavior therapy with a structured exercise program. Patients will complete multiple outcome instruments focusing on behavioral as well as subjective changes before and following treatment, and at 3, 6, and 12 month follow-ups. Study II assesses the efficacy of individual components of these treatments. Patients will be randomly assigned to: (a) a waiting list control condition, (b) group relaxation training, (c) group cognitive therapy, (d) group behavior therapy, or (e) group structured exercise program. The results of the study will have directly relevant implications for chronic pain patients, physicians and clinics treating this population, and insurance carriers, all of whom are concerned with how this extremely prevalent, costly, and refractory problem can most efficiently be treated. Clinical and experimental psychologists, and orthopaedic surgeon and a physical therapist, representing three medical school departments, will work closely together in the study.